应用 B+M 型超声波评估老年中风患者的吞咽困难。

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2025-02-01 DOI:10.1016/j.ultrasmedbio.2024.10.001

Jiaying Shuai , Linping Pian , Li Tian , Linying Wang , Miaomiao Deng , Chen Cheng

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引用次数: 0

摘要

研究目的本研究旨在通过 B+M 型超声波定量评估和比较吞咽过程中与吞咽相关的肌肉和骨骼运动模式，并探讨其在吞咽困难中的应用价值：研究对象： 60 名吞咽困难的老年脑卒中患者（患者组）和 60 名健康老人（对照组）。利用 M 型超声波测量舌和舌根肌运动的径向位移和持续时间。B 型超声波用于评估舌骨位移和舌骨-喉部近似距离。对两组患者的超声参数进行比较。采用逻辑回归法确定具有独立预测价值的最佳参数。使用 ROC 曲线分析评估了各参数对吞咽困难的预测效果：在三次吞咽过程中，B+M 模式成像轨迹均存在个体内和个体间差异。两组患者的舌和舌根肌运动的平均径向位移和持续时间、舌骨位移和舌骨-喉部近似距离均存在显著差异（均 p < 0.001）。与对照组相比，患者组的舌根肌径向位移、舌骨位移和舌咽近似距离较低，而患者组的舌根肌运动持续时间较长。逻辑回归选择舌的径向位移、舌根肌运动持续时间和舌-喉近似距离作为重要的预测因子。综合模型的AUC为0.994，模型拟合度良好（p < 0.001），显示出了卓越的预测性能：结论：B+M 型超声为初步评估吞咽运动提供了一种快速、安全的技术。结论：B+M 型超声波为初步评估吞咽运动提供了快速、安全的技术，可作为临床筛查吞咽困难的定量、无创方法。

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Application of B+M-Mode Ultrasound in Evaluating Dysphagia in Elderly Stroke Patients

Objective

The purpose of this study was to evaluate and compare the swallow-related muscles and bones movement patterns during swallowing quantitatively by B+M-mode ultrasound, and to investigate its application value in dysphagia.

Methods

Sixty elderly stroke patients with dysphagia (patient group) and sixty healthy elderly individuals (control group) were enrolled in this study. M-mode ultrasound was utilized to measure the radial displacement and duration of tongue and geniohyoid muscle movements. B-mode ultrasound was employed to assess hyoid bone displacement and the distance of hyoid-larynx approximation. Ultrasound parameters were compared between the two groups. Logistic regression was used to identify the optimal parameters with independent predictive value. The predictive efficacy of each parameter for dysphagia was evaluated using ROC curve analysis.

Results

Both intraindividual and interindividual variations were observed in the B+M-mode imaging traces during the three swallows. Significant differences were found in the average radial displacement and duration of tongue and geniohyoid muscle movements, hyoid bone displacement, and hyoid-larynx approximation distance between the two groups (all p < 0.001). The radial displacement of the tongue and geniohyoid muscle, hyoid bone displacement, and hyoid-larynx approximation distance were lower in the patient group compared to the control group, while the duration of tongue and geniohyoid muscle movements was higher in the patient group. Logistic regression selected the radial displacement of the tongue, the duration of geniohyoid muscle movement, and the hyoid-larynx approximation distance as significant predictors. The combined model demonstrated excellent predictive performance with an AUC of 0.994 and good model fit (p < 0.001).

Conclusion

The B+M-mode ultrasound offers a rapid and safe technique for the preliminary evaluation of swallowing movements. It can serve as a quantitative and noninvasive method for the clinical screening of dysphagia.

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.